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(
Nishi et al., 2003
). Aap of EAEC is secreted by many EAEC strains and was sug-
gested as a possible target for diagnosis (
Sheikh et al., 2002
). However, a recent
report demonstrates that Aap is also produced by non-EAEC strain. A multiplex
PCR assay was developed that detects the three AA plasmid-borne genes (
aatA,
aggR,
and
aap
) and studies showed that these loci are commonly but not invari-
ably linked (
Opintan et al., 2010
). The authors of this study found that 82% of the
EAEC strains isolated from patients with diarrhea were positive for the three loci
and that use of a multiplex assay increases both the sensitivity and the specific-
ity of EAEC detection (
Cerna et al., 2003
). Several studies have applied PCR in
detecting EAEC targeting genes
aggR
and/or
aatA
(
Kahali et al., 2004
;
Sarantuya
et al., 2004
;
Pereira et al., 2007
;
Regua-Mangia et al., 2009
;
Gomez-Duarte et al.,
2010
;
Opintan et al., 2010
;
Rugeles et al., 2010
). The variable results obtained
using molecular diagnostics may be due to the heterogeneity in EAEC pathogenic
mechanisms (
Okeke and Nataro, 2001
). PCR targeting both virulence factors on
the pAA plasmid and the chromosomal EAEC loci, such as
aaiC
(
Dudley et al.,
2006
) might prove to be the most advantageous approach in detecting EAEC.
REFERENCES
Philadelphia, p. 23
.
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